HomeMy WebLinkAboutDrain Layers Permit 019 Carriage Drive .k
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
JSouth Windsor, Connecticut B/P No.:
� List No.:
i _
DRAIN LAYER'S PERMIT Np 2588
19R
Pursuant to written applicatior, p fission is hereby g ted to the Licensed Drain Layer named herein to perfor
f the work indicated below at m ,
I on the
side, bet e n
at premises owned by Q-
whose address is
and to Lay House Drain, Repair House Drain, La Main,, Other
for
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE { j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side.-
thereof. Applicant has received Town Permit No. and/or CHD Permit No.
for street excavation.
SPECIAL CONDITIONS'
Signed
,-Connection Charge Pai Licensed Drain Layer
` Issued by
arCo to f
PJ( Permit Fee: Paid _
INSPECTION: Check Number: p
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)